al-jazeera america. >> welcome to al-jazeera america. i am john seigenthaler. detroit is officially bankrupt. the city can work up a plan to she had billions in debt. it could include cutting bi pensions for thousands of people. appeals are expected but the city manager, kevyn orr is moving forward. a crucial new clue in sunday's deadly train crash. a union official says the engineer at the control of the passenger train was nodding off shortly before the train veered off of the rails at break-neck speed. several investigators say there is no evidence of brake or rail failure president obama defending his healthcare site again.

he said he will come pain for it until december 23rdrd. >> that's the deadline to sign up for insurance coverage. overseas, vice president joe biden is in asia trying to ease tensions between japan and china. countries are fighting over a group of islands. in tokyo today, biden said the u.s. stands with japan. those are the headlines at this ho hour. i am john siegenthaler seeing. consider th "consider this" with antone i don't mora is next. you can always get the latest news on acceljazeera.com. we will see you at 11:00 o'clock. >> can getting stitches put you

in the poor house? medical costs have skyrocketed with sometimes absurd results. $500 per stitch? consider this: how do hospitals get away with it? th will it get better or worse with obamacare? also, an al jazeera exclusive brings new questions to light over iran's influentialing program. plus the energy drink business is exploding with little regulation. we will hear from a doctor whose new study is adding to growing concerns about the drinks' safety. can you live your life paying for everything by only using online currency? we will be joined by a couple who live in -- or who lived in the brave new world of bitcoin banking. hello. i am antonio mora. we begin with outrageous hospital bills. the mysterious methods hospitals use often puzzle experts. how can it cost one person in california $1,500 to get stitches when the person next to them is charged $500 more and

the same treatment in florida could cost over $3,000? as al jazeera's janet tuboni reports, higher costs do not necessarily equal better care. renewing a long-standing debate over how hospitals determine prices. >> hospital costs have americans fed up with the system. >> i think insurance companies and hospitals and healthcare in general are really over the top >> reporter: some even say they would circumvent care before paying. >> if you were going to get one stitch, would you pay $500 tore stitch yourself? >> i would try to stitch myself. >> to others, it's not so shocking. >> i am not surprised. there is a thing in america about like having competitiveness and an open mark, like market capitalization. the disparity in costs on this map represent the same procedures in different hospitals. some well a gap of over $90,000. >> you can go to one hospital, get a procedure that costs $7,000. you can go to another hospital, exact same procedure, $100,000.

>> you can go to europe or asia and get it for a third of that. >> patients here at the nyu medical center will pay the high cost of treatment and services look so many other americans but what they want to know is: what exactly are they paying for? >> some hospital administrators say the cost is due to highly trained professionals available at all times, upgraded equipment and building standards that meet expectations. >> i think that there shutted be more oversight probably in terms of how those costs are calculated. >> with a difference in opinion, one question is clear: where is the money going? >> giana tiboni, al jazeera new york. >> "new york times" core en respond event has been writing about this all year. her fifth article, paying until it hurts on the high cost of american healthcare appears in tuesday's edition of "the new york times." great to have you ever here, elizabeth. >> thanks. >> it's been said you need a ph.d. in economics to understand

how hospitals and hospital bills. you are a doctor in addition to being a journalist. but still, i don't know if you can explain this to me because i don't think anybody can. how in the world can you have a hospital charge $137 for a bag of saline for an iv when the thing costs a buck? >> the truth is hospitals charge what they can get away with charging in our system. there is no reason for them to do otherwise because we are the one country in the world that doesn't control prices. >> but how in the world can that make sense? let's look at some more of theseprises. saline, of course, being one example. you looked at a hospital in california, california pacific. some of these inflated prices. tylenol with codeine, the hospital price was 36.78. the market price, 5s $0.00. we talked about the iv fluid back, neck brace costs 20 bucks on the regular market. a knee orthro scopic hospital price $14,110. the market price, barely over $2,000. how in the world does a hospital

get away with that? who would go to a hospital and pay $14,000 if you could go somewhere else and do it for 2,000? >> the problem is in most of the u.s., you can't go to someplace else and do it for 2,000. the star of part 3 of our series went to belgium because he didn't want to get his hip replaced in the u.s. or he couldn't afford it. so i think if you shop around, you can get somewhat better prices, but our prices are universally inflated. >> but why can they get away with it, i guess is my question? because there are so many people involved in the process. >> well, because we don't pay those bills directly. i mean when you look at your hospital bill, you get your hip replaced, you get your explanation of benefits and you see that $99,000 and you think, whoa, what could cost that much? but your insurance is paying most of it. you may have a 2,000 dollar dedu deductible. beyond that, you are like it sounds crazy but it's not my problem. >> there is a ripple effect in the end that avenge affirmative all of us. >> sure but not one we see directly. we can't respond to prices. we don't experience them

directly and, you know, i challenge anyone to call around to hospitals and say, what's it going to cost to get my hip replacedd you can't get the price so how can you be a good consumer? >> you can't do that in most places. california is an example. they have to put these prices online. so you use, again, the example of california pacific. let's look at some of those prices. they put the stuff online. $33,000 for an x-ray study of the heart's arteries, more than two 5 grand for gallbladder removal. that doesn't include the doctor's fees, $5,500 for a simple delivery of a baby. that doesn't include 731 bucks extra for every hour of labor. so, oh, my god, if you have them in labor, you are in big trouble. they add on all sorts of other things. are those actual costs for the hospital, real prices, or are they just putting these inflated numbers out there as a beginning point, as a starting point for negotiations? >> well, they are -- they are cost shifting when they come up with those numbers because they

will say, they have all of these services but they aren't paid for, like nurses' salaries, like heating, cooling, you know, whatever. but basically, they pull numbers out of thin air. they say, what do we need to make? and then they adjust their prices for this, that, and the other to make that. now, you know, someone would say to me, well, look, your iphone doesn't cost $650. everyone marks things up. but there are no -- actually, this is healthcare. this is about people's survival, having a baby, kids getting immunizations. so the question is, do we really want that prices the way we have our cell phones priced? >> you end up paying the 650 bucks unless you are getting it through a provider with a contract. in this case, does everybody end up paying those $32,000 for the heart x-ray? >> well, you know, most of the insurers will negotiate rates. the poor -- the unfortunate people who actually are hit with those bills are people who don't have insurance, who don't have an insurer to argue on their behalf. but, you know, in a way, we all

pay because it's -- people say, why is my premium going up? this is why. >> why we have so many bankruptcy connected to it. >> right. >> then you see a doctor at that hospital talked about how medicaid only pays 10 to 20% of the costs. medicare, 70% of the costs. insurance companies often get about half of what those list prices are. >> right. >> so again, it just seems like such an odd game that's being played. >> it's a crazy system. it's a completely crazy system. we don't do anything else like this. if someone said do you see, you had someone come in to do your kitchen and they said the price is going to be 20 draws in br we will take $200,000 but we will take 30,000, how could you possibly have a system like that? and yet that's what we are doing with healthcare. >> and one thing that i really didn't understand, i guess i don't understand most of tin th but in california, again, you have to publish prices online, put the prices out there. but their emergency room costs are the highest in the country 50% higher than in the northeast. you would think if you were actually putting those prices

out there, it would lower prices. so how do they end up here? >> well, the thing is, putting prices on there is not making them accessible to actual human beings. the state, to its credit, said to hospitals, we want to see your charge masters. now, i use that as a list price, but it's not like a restaurant menu where there are five pages. it's 400 pages of medical coding terms. so, i trained as a doctor so i know what those codes mean. so i can tell you what they are charging for most things. i mean there were a lot of things like, you know, five-inch screw platinum, blah, blah, blah, that i don't know what it is and it's $7,000. so you can imagine if you say to your hospital, i want an itemized bill and you get this list of stuff, it's kind of meaningless. so california, to its credit has taken this first step. most states haven't even done that but in terms of being actually useful for patients, not really. >> you talk about all sorts of other things including how emergency rooms from gone from being money pits to money

makers. there, they jack up the costs. it's fascinating stuff, elizabeth. >> thank you. i hope everyone looks at prices a lot more it would be a fairer market. >> that's for sure if we knew what was out there. he liz beth rosenthal with the "new york times." great to have you here? >> thank you. for more on healthcare costs and whattrition to obamacare, we are joined by james robinson, professor of health economics. he joins us from our los angeles stud studio. great to have you with us, james. i think you do some things up nicely and asked an important question about healthcare and the "new york times." you said, quote, hospitals are self-fueling, ever-expanding machines. there is an infin ite amount of stuff to buy, am ebbities, new wings, higher salaries, more nurses. but to deliver good healthcare, what do you need? what do we need? and should they be charging what they are charging for those things we need? >> well, i think that there is really three inter-connected

aspects of the problem. the first is that the consumer doesn't have any way of knowing what the price ofhy is and the prices structured, as elizabeth was saying, that's so obscure, nobody can understand it. >> that's the first problem. the second one is that the prices, themselves are so -- there is not a single price for anything that you would actually want to buy. it comes out as these bits and pieces of, as she put it, screws and bolts and bandages and aspirins when what you really care about is: what's my care going to cost me? what's that whole doctor visit going to cost me? what's the whole admission to the hospital going to cost me that's not prized that way? the third is that the consumers often don't care because somebody else is paying for it. we don't care what something costs if someone else is paying. all three of those need to be addressed if we are going to have any rationality in the healthcare pricing system. >> in many ways, it really is completely anti-capitalistic because you end up not knowing what you are buying. so, it really is an aberration to the

rest of of our economic system. >> it's a peek you'll yar world because it is a market system but because of insurance and the wait insurance is structured, we are all like we are drugged. we don't care, we don't know. through higher premiums and taxes. at the time we are receiving care, we have this illusion that someone else is paying for t even if we try, do a diligent job of trying to understand what things cost, we get these pricing schedules which are incomprehensible. >> you have been out spoken on how it is the biggest driver of rising healthcareh health insurance premiums but the outrageous costs have been known for years. so why hasn't the outrage over this taken us anywhere? >> it's hard to understand. we used to -- we used to say that healthcare costs couldn't rise above 10% of gdp. people would be outraged. now, it's about 18% and seems like it's just going higher. i really think that the fundamental issue is that really, people have believed

that someone else is paying for their healthcare raernling themselves. this is the great illusion of healthcare, that we are not paying for it. >> is that illusion going to get worse under alabamacare? the president is making a renewed push and stressing costs. let's listen to what he had to say. >> the website is working for the vast majority of people. we need to make sure that folks re-focus on what's at stake here, which is the capacity for you or your families to be able to have the security of decent health insurance at a reasonable cost. >> so in the short and long-term, what do you think obamacare will mean for the cost of care? >> i think that it will have the two different effects. it will have some cost-reducing effects because it will help consumers make more apples to apples comparesons across health plans and, hopefully, across

doctors and hospitals. >> that's a little bit more to be seen. that's very important so the consumer is making their choices. on the other hand, i think we have to admit that the administrative costs of this whole system are high. and really, unfortunately, obamacare is layering another layer of complexity on a healthcare system which is already groaning under the sur plex complexity of our system, which expensive.

>> what about that? you said in the recent article that the average stay around the world is about $6,000. in the u.s., it's over 18,000. what if the quality -- what is the quality of care here compared to other developed nations? >> i think all of the studies are pretty clear on this that the quality of care in the united states is about comparable to the other industrialized nations such as canada or the european nations or australia. so we spend more, gu we don't get more. we just have this unbelievably convoluted system and we need to make it more simple. we need to have the consumer, the patient, more engaged in understanding and caring about what it costs, and then we need the healthcare system, the hospitals, the doctors, the pharmaceutical companies, to respond to a consumer, an

interested and informed consumer by making their prices more understandable. frankly to compete on the basis of price, which will drive prices down over time. >> james robinson, really appreciate you joining us to try to make some sense out of this, this big mess. we appreciate you joining us. thank you. >> my pleasure. >> coming up, an al jazeera exclusive minister with iran's foreign ministers raises more concerns about the country's nuclear ambitions. we will have analysis next. let's going back to hermela. >> the night against low wages is taking on the banking industry. i will tell you more coming up. what do you think? join the conversation on twitter @ajconsiderthis and on our facebo+ our facebook and ogolog google+

weeknights 7:30 et / 4:30 pt on al jazeera america and join the conversation online @ajamstream. power of the people until we restore our free

>> from debt to america to let's make a deal.

jamar zarif has wrapped up a diplomatic charm offensive after wrapping up an interim deal on iran's nuclear program. zarif gave an exclusive interview to al jazeera english where he emphasized again that iran's nuclear program will go on at least partly on iran's terms. >> iran will continue its enrichment at 5%. and iran will continue construction work at iraq. >> for more here in new york is nadir sh ar mi at the joseph corevel at the university of denver. also, the co-of a new book, the syria dilemma. you heard zarif speaking. he insisted they don't want nuclear bombs. as you heard, he is insisting on continuing work at the plant

that the nuclear re actor at iraq which would be able to produce plutonium for nuclear bombs. he said they continue to have the right to enrich. you have this conflict between what the ir ranians are saying d what john kerry is saying. >> both sides are trying to spin it for domestic audiences. we have to judge iran not by what the foreign minister is saying but what iran has committed itself to by virtue of the general eva agreement, what it's doing on the ground. i think what we are hearing is iran wants to show it has not capitulated to the international community. when you look at the general eva agreement, iran has made a an almost 180 degree turn. it had to accept the dmrandz of the international community. this is a full-scale c capitulation by iran that it had to make in the case of very concerted western efforts. >> let's look at some more of what zarif said. is it all spin?

most of us think the economic sanctions are what led iran to the negotiating table, but he had this to say: >> when sanctions started, iran had less than two 00 centrifuges. today, 19,000. so the product, the net product of sanctions has been about 18800 centrifuges added today iran's stock of centrifuges. on the other hand, the people of iran blame the west for instructions that have been imposed on their livelihood, on their ability to buy medicine, on their ability to finance and purchase food items from abroad. >> so does he have a point? that, in fact, the saifrpingsz have led to iran getting more and more centrifuges and developing their own nuclear program creating some sort of resentment? >> he is saying that for domestic constituents.

one has to ask why did it come to an agreement that it previously had rejected in previous years? he is saying it's not because of the sanctions. i think most reasonable people know the sanctions has devastated the iranian economy. the reason why iran has made this about-face, signed the geneva agreement, because it realized its economy, the future of its regime was headed toward disaster. it had to make a compromise. >> that's what's going on. >> zarif said and insisted that iran's nuclear program is for peaceful purposes and transparent. >> we have nothing to hide. they have been searching iran up and down, in and out, for the past 10 years probably more than they have searched any other country on the face of this earth. and they have not found a single evidence of diversion of our nuclear program into anything other than peaceful purposes. >> if you watch him.

is he as netanyahu said on, a wolfe in sheep's clothing? >> i am a reminded of a diplomat who says an ambassador is someone who is a nice gentleman who is sent abroad to lie for the good of his country. we are seeing that in his statements, that he is a very likeable statements but these statements have to be deciphered and interpreted. >> is clear, they hit the nuclear facility and they have tried to hide all sorts of things. >> right, or ask the question: why weren't international inspectors given full access to iran before? why do we have to wait until this agreement if iran really had nothing to hide, why were we going through this whole process of sanction and debate? we could have resolved this 10 years ago. >> is he expected to be believed 1234. >> he is representing the interests of his country. i think he is really not speaking to a western audience. he is really speaking to an iranian audience, particularly those segments of the hard-line constituency that don't like

this agreement that are sort of making noises that they are unhappy but for now, they are sort of contained. i think that's what he is trying to accomplish. >> he is also trying to get friendliar with the arab gulf states. he did everything he could to sort of sooth feelings there. let's listen to some of this as he blamed, of course, most of the tension in the region on one country. >> it continues to be israel that continues to do everything in its power in order to derail the process and in order to prevent it from implementation. our friends in the region have nothing to lose. our friends in the region have nothing to fear. >> so here, is he going further than just oman and qat ar? is he reaching out to saudi arabia? >> i think he is trying to. this is a new, almost historic 1 can say push by iran to try to bridge with his neighbors. this is a new outreach. i think he is speaking to saudi arabia, the key player in the region. he hasn't gone there yet.

but you can tell iran is not only trying to reach out to the west diplomatically and resolve problems but the same on a regional effort. i think that explains the foreign minister's trip. >> one place you know about and there has been a lot of conflict between saudi arabia and iran is syria. and this is what zarif had to say about what needs to happen there. >> there is no military solution to the tragedy in syria. we need to bring all of the people together. extremenism syria will harm all of us. extremism in syria cannot be contained to syria. our friends in the region will be the first targets and victims of extremism. >> this is a guy who works for a government that supports the extremists of hezbollah. so, is there anything chance that iran will accept anything other than a solution in syria with assad staying in power? >> it won't. for the foreign minter to talk about extremism, there is no

military solution when iran is deeply militarily involved is the height of hypocracy. yesterday, the u.n. rights, said they are guilty and the highest levels of the state are responsible. >> that's the biggest form of extremism instruments having and seeing in syria that is responsible for the deaths of over 100,000 people. so it's the height of hypocracy for the foreign minister to complain about he knew treme whichl his government is backing the most extremist players in syria today. >> the charm offensive continues. are people buying it and whether it will work? we will stay on top of it. i hope you will join us again. great having you on the set. moving on to another member of what former approximately george w. bush called the axis of evil, north korea where the country's second most powerful leader appears to have disappeared while a new hostage seems to make a coerced con sfeings. according to south korea's

intelligence service, the number 2 after his nephew, kim jun un has been dropped from power after two deposit treys executed for corruption and anti-party activities. meanwhile, relatives say they are deeply worried about 85-year-old newman. he has been detained for over a month after he was pulled from a jet liner was a he was leaving korea after a 10-day tour. i am joined by jordan chain and the author of "nuclear showdown: north korea takes on the world ". number 2, married to kim lu kim lun yun's ant, also a pour in her own right. has he been removed from power? >> i think that he has because he hasn't been seen in public since november 6th. that would be very unusual if he indeed were not purged.

there have been a number of other indications that he actually has been removed from power. so i think that these stories are pretty much on the mark. >> what does this rule from power, if that's what happened here, what does it say about the power struggles in north korea? is this basically just kim june un trying to take role? >> most people say this shows the regime is stable. if kim jung un didn't feel confident, he wouldn't have removed his number 1 power backer. this is a dangerous time for north korea. the reasons is that period of success, going from the father to the current ruler, the real different time is, i think, when the leader feels confident to act. he will strike out on his own and that means he will get himself in trouble. there are a lot of people in this regime who have been purged so there is a lot of resentment. >> this is a young guy. he hasn't been if power that long. >> i think: for instance, these

discussions we have heard of the a aids, this can't be a good sign because, you know, the killing is very hard to stop and blood demands blood. >> what about his aunt who is married to yun sin tak? >> she hasn't been feeling well for some time. i think she is pretty much out of the picture. she is the daughter of ki kim il sung, the founder of north korea. they can't really do anything to her. >> the grandson can't deal with his aunt? he can't move against here? ? >> no. >> but can he move against the uncle? >> he can sort of sideline him. i don't think he actually can kill him though because, you know, the myth of the kim family is just so powerful. you just cannot get someone, en someone who is not a blood line relative, blout related to marriage. >> let's turn to merle newman, 85 years old, a core e a war vet. they pull him off of an airplane while he was leaving. why are they holding him? >> a couple of reasons. the koreans, they are still fighting the korean war.

merrill newman that the it was over. he tried to contact some of his comrades, the partisans resisting north korea. plus we have to remember that one of the founding myths of north korea was that it was a tacked by south korea and the united states. this gives the regime a lot of opportunity to replay that story for the north korean people. this is very handy. >> let's talk about what you just said in the context of this terrible taped con vehicle. confession. >> which really brings back the worst possible memories of the cold war. as we look at him here reading this clearly coerced confession, he basically signed or they say he signed a confession committing hostile acts against north korea according to his war service. he said he was guilt of a long list of crimes during the war when he helped the guerillas, that he killed soldiers and planned to him some of his

soldiers connect with an anti-communist organization and he begged for pardon on his knees. what are the north koreans thinking? i knew that's an obvious question we ask because of all of the questions they do but to make an 85-year-old doll all of this and humiliate him knowing that the united states is going to be upset is incomprehension ill. >> it is to us but for the north korean people, this helps the regime, it shows the regime is able to take an american and put him on his knees, at least figuratively. so, it is going to play very well in north korea. of course, outside of north korea, it's reprehintible. it's really horrific. >> do you think this turmoil that we are seeing now with the unc uncle, will it make things worse? it's not just merrill newman. we have kenneth bay who has been a prisoner now for months in north korea. he has been held there for more than a year. is it more or less likely we will be able to get these guys

out? >> i think that's a great question, and the reason is that a very highly charged atmosphere, nobody wants to make a mistake. so the safe thing to do is the to do nothing. i think kenneth bay and merle newman will be held for much longer than they otherwise would have been. >> what game are the north korean's playing? trying to get more concessions from the united states, more aid? >> sure. they would love more aid. you know, they would like some other things from us as well. but i think at the end of the day, this is sort of dropped into their lap. they've got to do something about it. it comes at a bad time for both of those guys. so i think that essentially, this is sort part coincidence, but, also, you know, now that they are there, they are going to milly this to the max. >> for both of these men and their families, i hope something happens and they get out of there soon. gordon change, it's great to have you? >> thank you. >> time to see what's trending on ashingsdz america's website. >> starting wednesday there will be a week of protests in new

york city against low wages in the banking industry. they say there is a huge difference between what retail bankers manned make and what those in the corporate offices are paid. according to the bureau of labor and stadistics, a national median salary for bank tellers in 2012 was almost $25,000. about $2,500 more than the median salary of wal-mart workers. activists point out that tellers and other retail staff are usually required to buy suits at their expense and look the part of professional workers. what's more, last year, 39 percents of bank tellers in new york state relied on public assistance to get by while j.p. morgan chase jamie diamond made $21 million. now, to your reaction. viewer john kayes 0 says so long as corporates treat we should union eyes. >> wedged to the gilded age of 2.0. read more at al jazeera

america.aljazeera.com. >> many loch to down energy drinks. the author of a new studiey joins us next. later, are men only using half their brain? the new research that could have plenty of wives saying, "i've known that for years." ♪ and a host willing to ask the tough questions and you'll get... the inside story ray suarez hosts inside story weekdays at 5pm et / 2pm pt only on al jazeera america new details on what lead to that deadly plane crash in new york. the commuter train was traveling far too fast, more than 80 miles an hour down the track. the question is why? lisa stark joins us from washington. what is the latest? >> that train should have been going at 30

miles an hour around the curve. there are no published reports this morning including from wabc, those reports indicate that the engineer, william rockefeller has said he may have zoned out at the controls. he may have dosed off and then snapped awake too late to stop the train in time the ntsb will continue to interview the engineer and also look back at

do energy drinks pose significant health risks? a new medical study shows they can cause heart con tractions. energy drink related emergency visits have downhilled over the past 4 years with most cases involving teens and young adults. still, business is booming. energy drink consumption doubled from 2007 to 2011. more than $12,000,000,000 worth of energy drinks were sold last year and some estimates say sales will reach more than 21 billion within five years. dr. yonas dorner at the university holiday in bon germany offered the study and presented it at the annual

meeting chicago and he joins us from there. dr. dorner, thank you for joining us. we should note that your findings aren't peer reviewed yet, but you found that healthy adults could experience increased heart con tractions an hour after consuming an energy drink. in laymen's terms, what are the biggest impacts that could have on the heart? >> that's exactly right. we investigated young, healthy volunteers before and one hour after energy drink consumption. we managed an increased contr t contractibility one hour after con subtle. it's basically what you can say a strength in palm functioning. >> so i guess my question is: is what does that mean? your study comes on top of the american heart association study in martha found that energy drinks could increase blood pressure and change the heart's

rhythm. so is there something people should be concerned about? especially in the long-term? >> we investigated only short-term effects. as i said, we investigated the effects much energy drinks one hour after consumption. the dose of energy drink we used was relatively small. so, the precipitants had about 100 mil i graham capk caffeine and 1.4 graham toline, which is approximately 1/10 of energy drink. so, from our study, it is unclear if there is a dose dependence effect of injury drinks or not. we only investigated, as i said, little dosages which showed an increase in contractility which is, from our point of view, is no concerns in healthy volunteers at least at those

levels. >> so the question is: what are the risks? >> right. >> what are the biggest issues with the drink? is it the caffeine or the taurine? the taurine has been shown to increase contractility but to be positive in people who have serious heart problems? >> therefore, we investigated 10 participants using a caffeine-only protocol which includes the same amount of caffeine the energy drink did and we did not find a significant increase in contr t contractibility as we have seen it in the energy drink group. so probably, it is the tauline or the combination of the i n d ingredients the energy drink that causes this change in contractibility. >> looking at the amount of caffeine in the drifshingz, we looked at this and the five-hour energy drink contains more than 109 milligrams of caffeine per fluid ounce, five times the amount of a regular starbucks

coffee. nor 30 times more than a can of coke. monster energy is about three times more per fluid ounce that than a can of coke. is the problem people are just drinking more because, you know, the monster energy or the rock star or the red bull in many cases are just bigger cans and they are just drinking more amounts, more fluid ounces and thus, really bringing in a lot of caffeine? >> probably that's exactly right. so, the usual consumer of energy drinks often consumes more than one can. and as you said, the amount of caffeine in energy drinks is much higher than in calfnated sodas like coke a or cola. the amount you can intake in a short period of time can be much

higher than compared to sodas. >> we have had tens of thousands of people who have gone to emergency rooms. i think 20,000 in a year, in the most recent numbers. is the problem mostly the drinks, themselves, or the fact that people are combining the drinks with alcohol? >> that's a very good question. i think there is actually a register which tried to investigate this. i think there are issues about highs caffeine intake and, of course, the combination of alcohol and energy drinks, consuming from college students, et cetera. >> there has been some push back about your research from among sister energy drinks. they released a statement that said that some of your statements are false and inaccurate. they said in part that the authors' study does not document a negative effect on heart function although he concludes the consumption of energy drinks

should be restricted based upon his study. this conclusion is unsupported by his data and highly misleading. no evidence exists that increased contractility causes arrythmi arrythmia. what do you respond to them? >> as i said, we investigated short-term effects of energy ingredients and we saul a contract tilty change which we can measure using an advanced mri technique which is able to measure very delivered changes contractedility. we used a small dosage in healthy volunteers. there are no concerns about a reason alan intake of energy drink in such a cohort. but as we talk, the amount of caffeine or in energy drinks are much higher than in carbonated sodas. so, if you have an intoxication caused by highs amounts it was

caffeine, then the adverse side effects can be more efficient than in cola or sodas. so we investigated only sho short-term effects and we saw little difference and we have no concerns about consuming energy drinks in a healthy cohort. >> in a healthy group of people. >> yes. >> but as long as it's not an excessive amounted. 400 milligrams, i believe, is the number that the united states u.s. government recommends you do not exceed. if you were telling people, okay. well, how safe are these energy drinks? if you want to drink one or two, is that okay a day? how many can you drink and feel comfortable that you might not -- that you won't have any problems? >> the purpose of our study was just to investigate the effects of energy drinks on contra contractility and we didn't have pree measured or studied risks orbit of energy drink

consumption. >> right. do you worry? do you worry? from your standpoint, you don't think there is a problem if people drink a couple of cans a day? >> as long as we know, in healthy volunteers or in healthy people, there is no concern about reasonable intake of energy drinks. >> are you going to further the study, go further and try to analyze the drinks more? >> yes, well, or there should have -- there should -- there have to be more studies concerning long-term effects and effects on patients with known heart disease probably. maybe there is a dosage dependency which you can investigate. >> dr. jonas dorner, we really appreciate you joining us tonight. thank you. >> coming up, is it possible to live your life on bitcoin?

we have a couple who did just that. they had their guns on me and everything.... >> how much more real can this get? >> fault lines only on al jazeera america

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each other. don't get rid of us men yet. we could come in handy some day. coming up: is it possible to live your line using only online money? we will get a first-hand account of two people who did that. after the break.

>> and now, a techknow minute...

is it possible to survive on bitcoin, the unpredictable kunks see that exists digitally. only a handful accept it as payment. most never heard of it. that didn't stop our next guest from embarking on a worldwide trip. >> i am becky, soon to be becky. >> we are going to live first 90 days of our post-honeymoon married life on nothing but bit coyne. >> we will use bitcoin to barter. we will tell you what works,

doesn't work and why. >> we are joined by austin craig, "life on bitcoin." ? >> i have been interested in bitcoin but i don't have a background in economics or criptograpy. it was in production and marketing. i wouldn't to become involved in some way. this seemed like the best way to not only learn about it but to contribute maybe some education of this burgeoning field of a really obscure, difficult-to-understand area. >> let's try to understand it. you get back from your honeymoon. you married becky, get back and a day later, you embark on this journey where you were going to try to pay for everything with bit coyne. how do i get food? how do i get gas? >> it started right when we landed in the airport back if our honey moon. our task was how to figure out how t how to get home from the airport. we had to per sweet payment to accept bitcoin. when we started, there was only

one establishment in the entire state of utah. there was one barbecue restaurant outside of provo. outside of that, we had to approach merchants and say action hi, have you heard of bitcoin? no no. >> can we pay you with this? >> you managed to get groceries, a gas station about an hour away that you had to drive to in order to get gas which sort of somewhat defeats the purpose, i guess. so you manage to get those e sessions. now you decide what you are going to do is have this three-month trip around the world and do a road trip from provo a lot way to new york. how is that? >> we had to rely heavily on the bitcoin community. they are not merchants that accept bitcoin. certainly not for gas. gas stations are owned by oil companies. they are not interested in -- >> a new way of paying? >> right. >> what does it mean to get the community behind you? we had to meet up with bit coiners all along the way.

we were able to persuade some to accept bitcoin. we had to use in tweens. >> if you do get a business that disagre agrees to do this, what do you have to do? a transfereelectronically from your computer, you send a code to their computer and you figure out what the cost is based upon the currency value? >> from theition is not that complex indicated persuading somebody to give it a try. i can set you up to accept bitcoin in a few minutes. it's not difficult. the hard part is getting somebody to understand it and have a little confidence in the system that otherwise seems straight. now you are getting on an airplane going to berlin. you are going to stockholm, singapore, going around the world. was that all done through a travel agency?

>> for the airlines and for the hotels, we did rely on the travel agency. there was an agent in germany that we got all of our flights through and most of our hotel stays. when we got there -- >> how about transportation? >> we were on foot a lot. >> how about from the airport? >> from the airport, we frequently, i think, three times on our trip, we met up with somebody at the training station and sometimes we would go to the train station and just find a stranger and say hi, have you ever heard of bit coin? let me explain it to you. we want to pay you with this. we did that three times. three times, the first person we approached said i will give it a shot. >> do they have to create a bit coin account so that you can transfer money into their account, i would assume? >> yeah. they do have to have a bitcoin wallet like you have an e-mail address for e-mails. but it's straightforward and simple to set up. it's a matter of punching in a few things on your cell phone. >> we have a social media question for you. let's go to hermela of that? >> austin on twitter wants to

know if is bitcoin is worth $1,000, how do you buy a cup of coffee with it? >> that's a very good question. bitcoin can be sub divided out to the 8th desmil point. because it's did i kn because it's digital, you can pay. we don't have the vocabulary. we have dimes and nickels and quarters. that doesn't exist yet for bitcoin but i imagine it will as it becomes more commonly used. >> you have to do a lot of calculating and convincing because to eat at restaurants, to survive as you did abroad for three months, must have had to spend a lot of time and a lot of energy to get this done. >> yeah, becky, thankfully has a full-time job and she was at her job almost every day. i was frequently out trying to persuade local merchants to accept bitcoin. it took a couple of weeks to find a grab. >> did you ever go without eating? >> we did a couple of times. and that was mostly when we were traveling to new areas where we had not been able to contact

merchants and persuade them yet. one night in the stockholm, we were hung re. the next morning we found a restaurant that served excellent swedish food and found a boutique hotel. >> did you ever cheat? >> no. never. not once. i was amazed how many people would pull out the credit card. >> richard branson announced that virgin atlantic will be -- not virgin atlantic. his space company is going to accept bit coin as payment and because, it makes more sense. it's a space company, modern technology. it begs the question of will we see bitcoin as a frequently accepted mode of payment in the future? >> i think we could. when the infrastructure is in place and the merchant accepts it, it's more security than a credit card payment. it's a matter of having those things in place and having people understand how it works. >> do you think there will be

the technology, you can make these transfers and it's simple to do? >> it's that way right now. again, the matter is how universal it is, how often people have heard of it, accept it and are willing to take it for their business. right now, that's the limiting factor, not the technology, itself. >> when bitcoin or when you started your travels, bitcoin was worth about $100. right now, it's inflated. there is a big bubble going on. it may be a bubble, but it's over a thousand dollars. did you ever think maybe i should have saved that bitcoin? >> i don't because really, i went into this wanting to learn more about it. the rise in value of bitcoin just begs the question even more: is this viable as a currency if it's rising in value, can you use it as a currency? because that kind of volatility is really extreme. it's really interesting. i look forward to your documentary. appreciate you being here. >> thank you. >> the show may be over. the conversation continues on

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